WAR ON DRUGS REPORT OF THE GLOBAL COMMISSION

WAR
O N DR UGS
R E P O RT O F TH E
G LO B A L CO MMIS S ION
ON D R U G P O LICY
JUN E 2011
REPOR T OF THE
GLOBAL COMMISSION
ON DRUG POLICY
C OMMISSIONERS
Asma Jahangir, human rights activist, former
UN Special Rapporteur on Arbitrary, Extrajudicial and
Summary Executions, Pakistan
Carlos Fuentes, writer and public intellectual, Mexico
César Gaviria, former President of Colombia
Ernesto Zedillo, former President of Mexico
To learn more about the Commission, visit:
www.globalcommissionondrugs.org
Or email: [email protected]
Fernando Henrique Cardoso, former President of
Brazil (chair)
George Papandreou, Prime Minister of Greece
George P. Shultz, former Secretary of State, United States
(honorary chair)
Javier Solana, former European Union High Representative
for the Common Foreign and Security Policy, Spain
John Whitehead, banker and civil servant, chair of the
World Trade Center Memorial Foundation, United States
Kofi Annan, former Secretary General of the United
Nations, Ghana
Louise Arbour, former UN High Commissioner for Human
Rights, President of the International Crisis Group, Canada
Maria Cattaui, Petroplus Holdings Board member,
former Secretary-General of the International Chamber of
Commerce, Switzerland
Mario Vargas Llosa, writer and public intellectual, Peru
Marion Caspers-Merk, former State Secretary at the
German Federal Ministry of Health
Michel Kazatchkine, executive director of the Global Fund
to Fight AIDS, Tuberculosis and Malaria, France
Paul Volcker, former Chairman of the United States
Federal Reserve and of the Economic Recovery Board
Richard Branson, entrepreneur, advocate for
social causes, founder of the Virgin Group, co-founder
of The Elders, United Kingdom
Ruth Dreifuss, former President of Switzerland and
Minister of Home Affairs
Thorvald Stoltenberg, former Minister of Foreign Affairs
and UN High Commissioner for Refugees, Norway
E XE CUTIVE SUMMARY
The global war on drugs has failed, with
devastating consequences for individuals
and societies around the world. Fifty years
after the initiation of the UN Single
Convention on Narcotic Drugs, and
40 years after President Nixon launched
the US government’s war on drugs,
fundamental reforms in national and global
drug control policies are urgently needed.
Vast expenditures on criminalization and
repressive measures directed at producers,
traffickers and consumers of illegal drugs
have clearly failed to effectively curtail
supply or consumption. Apparent victories
in eliminating one source or trafficking
organization are negated almost instantly
by the emergence of other sources and
traffickers. Repressive efforts directed at
consumers impede public health measures
to reduce HIV/AIDS, overdose fatalities
and other harmful consequences of
drug use. Government expenditures on
futile supply reduction strategies and
incarceration displace more cost-effective
and evidence-based investments in
demand and harm reduction.
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Global Commission on Drug Policy
Our principles and recommendations can
be summarized as follows:
End the criminalization, marginalization
and stigmatization of people who use drugs
but who do no harm to others. Challenge
rather than reinforce common misconceptions
about drug markets, drug use and
drug dependence.
Encourage experimentation by governments
with models of legal regulation of drugs to
undermine the power of organized crime
and safeguard the health and security of
their citizens. This recommendation applies
especially to cannabis, but we also encourage
other experiments in decriminalization and
legal regulation that can accomplish these
objectives and provide models for others.
Offer health and treatment services to those
in need. Ensure that a variety of treatment
modalities are available, including not just
methadone and buprenorphine treatment but
also the heroin-assisted treatment programs
that have proven successful in many European
countries and Canada. Implement syringe
access and other harm reduction measures
that have proven effective in reducing
transmission of HIV and other blood-borne
infections as well as fatal overdoses. Respect
the human rights of people who use drugs.
Abolish abusive practices carried out in the
name of treatment – such as forced detention,
forced labor, and physical or psychological
abuse – that contravene human rights
standards and norms or that remove the
right to self-determination.
Apply much the same principles and
policies stated above to people involved
in the lower ends of illegal drug markets,
such as farmers, couriers and petty sellers.
Many are themselves victims of violence
and intimidation or are drug dependent.
Arresting and incarcerating tens of millions
of these people in recent decades has filled
prisons and destroyed lives and families
without reducing the availability of illicit
drugs or the power of criminal organizations.
There appears to be almost no limit to
the number of people willing to engage in
such activities to better their lives, provide
for their families, or otherwise escape
poverty. Drug control resources are better
directed elsewhere.
Invest in activities that can both prevent
young people from taking drugs in the
first place and also prevent those who do
use drugs from developing more serious
problems. Eschew simplistic ‘just say no’
messages and ‘zero tolerance’ policies
in favor of educational efforts grounded
in credible information and prevention
programs that focus on social skills and peer
influences. The most successful prevention
efforts may be those targeted at specific
at-risk groups.
Focus repressive actions on violent
criminal organizations, but do so in ways
that undermine their power and reach
while prioritizing the reduction of violence
and intimidation. Law enforcement
efforts should focus not on reducing drug
markets per se but rather on reducing their
harms to individuals, communities and
national security.
Begin the transformation of the global
drug prohibition regime. Replace drug
policies and strategies driven by ideology
and political convenience with fiscally
responsible policies and strategies
grounded in science, health, security and
human rights – and adopt appropriate
criteria for their evaluation. Review the
scheduling of drugs that has resulted
in obvious anomalies like the flawed
categorization of cannabis, coca leaf and
MDMA. Ensure that the international
conventions are interpreted and/or revised
to accommodate robust experimentation
with harm reduction, decriminalization and
legal regulatory policies.
Break the taboo on debate and reform.
The time for action is now.
Global Commission on Drug Policy
3
INTR ODUC T IO N
U N I TE D N ATION S E STIMATE S O F ANNUA L DRUG
CO N S U MPTION, 1998 TO 2008
Opiates
Cocaine
Cannabis
1998
12.9 million
13.4 million
147.4 million
2008
17.35 million
17 million
160 million
% Increase
34.5%
27%
8.5%
The global war on drugs has failed. When the United
Nations Single Convention on Narcotic Drugs came into
being 50 years ago, and when President Nixon launched the
US government’s war on drugs 40 years ago, policymakers
believed that harsh law enforcement action against those
involved in drug production, distribution and use would
lead to an ever-diminishing market in controlled drugs
such as heroin, cocaine and cannabis, and the eventual
achievement of a ‘drug free world’. In practice, the global
scale of illegal drug markets – largely controlled by
organized crime – has grown dramatically over this period.
While accurate estimates of global consumption across the
entire 50-year period are not available, an analysis of the
last 10 years alone1,2,3,4 shows a large and growing market.
(See chart above.)
In spite of the increasing evidence that current policies are
not achieving their objectives, most policymaking bodies
at the national and international level have tended to avoid
open scrutiny or debate on alternatives.
4
Global Commission on Drug Policy
This lack of leadership on drug policy has prompted the
establishment of our Commission, and leads us to our view
that the time is now right for a serious, comprehensive
and wide-ranging review of strategies to respond to the
drug phenomenon. The starting point for this review is
the recognition of the global drug problem as a set of
interlinked health and social challenges to be managed,
rather than a war to be won.
Commission members have agreed on four core principles
that should guide national and international drug policies
and strategies, and have made eleven recommendations
for action.
P R I NCI P L ES
1. Drug policies must be based on solid empirical and
scientific evidence. The primary measure of success
should be the reduction of harm to the health,
security and welfare of individuals and society.
In the 50 years since the United Nations initiated a truly
global drug prohibition system, we have learned much
about the nature and patterns of drug production,
distribution, use and dependence, and the effectiveness
of our attempts to reduce these problems. It might have
been understandable that the architects of the system
would place faith in the concept of eradicating drug
production and use (in the light of the limited evidence
available at the time). There is no excuse, however, for
ignoring the evidence and experience accumulated
since then. Drug policies and strategies at all levels too
often continue to be driven by ideological perspectives,
or political convenience, and pay too little attention
to the complexities of the drug market, drug use and
drug addiction.
Effective policymaking requires a clear articulation of the
policy’s objectives. The 1961 UN Single Convention on
Narcotic Drugs made it clear that the ultimate objective
of the system was the improvement of the ‘health and
welfare of mankind’.
This reminds us that drug policies were initially
developed and implemented in the hope of achieving
outcomes in terms of a reduction in harms to individuals
and society – less crime, better health, and more
economic and social development. However, we have
primarily been measuring our success in the war on
drugs by entirely different measures – those that report
on processes, such as the number of arrests, the
amounts seized, or the harshness of punishments. These
indicators may tell us how tough we are being, but they
do not tell us how successful we are in improving the
‘health and welfare of mankind’.
2. Drug policies must be based on human rights
and public health principles. We should end the
stigmatization and marginalization of people who
use certain drugs and those involved in the lower
levels of cultivation, production and distribution,
and treat people dependent on drugs as patients,
not criminals.
Certain fundamental principles underpin all aspects of
national and international policy. These are enshrined
in the Universal Declaration of Human Rights and many
international treaties that have followed. Of particular
relevance to drug policy are the rights to life, to health,
to due process and a fair trial, to be free from torture
or cruel, inhuman or degrading treatment, from slavery,
and from discrimination. These rights are inalienable,
and commitment to them takes precedence over other
international agreements, including the drug control
conventions. As the UN High Commissioner for Human
Rights, Navanethem Pillay, has stated, “Individuals
who use drugs do not forfeit their human rights. Too
often, drug users suffer discrimination, are forced to
accept treatment, marginalized and often harmed by
approaches which over-emphasize criminalization and
punishment while under-emphasizing harm reduction
and respect for human rights.”5
A number of well-established and proven public
health measures6,7 (generally referred to as harm
reduction, an approach that includes syringe access and
treatment using the proven medications methadone or
buprenorphine) can minimize the risk of drug overdose
deaths and the transmission of HIV and other bloodborne infections.8 However, governments often do not
fully implement these interventions, concerned that by
improving the health of people who use drugs, they
are undermining a ‘tough on drugs’ message. This is
illogical – sacrificing the health and welfare of one group
of citizens when effective health protection measures are
available is unacceptable, and increases the risks faced
by the wider community.
Global Commission on Drug Policy
5
P R I NC IP L ES
(Continued)
IMPA C T OF DR UG POLICIE S
O N R E CE N T H IV PR E VALE N CE
A M O N G PE OPLE WH O
IN JE C T DR UGS 9
Sample of countries that have consistently
implemented comprehensive harm reduction
strategies:
Countries that implemented harm reduction and public
health strategies early have experienced consistently low
rates of HIV transmission among people who inject drugs.
Similarly, countries that responded to increasing HIV
prevalence among drug users by introducing harm reduction
programs have been successful in containing and reversing
the further spread of HIV. On the other hand, many countries
that have relied on repression and deterrence as a response
to increasing rates of drug-related HIV transmission are
experiencing the highest rates of HIV among drug using
populations.10,11,12
UK
Switzerland
Germany
Australia
0 5 1015202530354045
% HIV prevalence among people who inject drugs
Sample of countries that have introduced harm
reduction strategies partially, or late in the
progress of the epidemic:
USA
Portugal
Malaysia
France
0 5 1015202530354045
% HIV prevalence among people who inject drugs
Sample of countries that have consistently
resisted large scale implementation of harm
reduction strategies, despite the presence of
drug injecting and sharing:
Thailand
Russia
0 5 1015202530354045
% HIV prevalence among people who inject drugs
6
Global Commission on Drug Policy
An indiscriminate approach to ‘drug trafficking’ is similarly
problematic. Many people taking part in the drug market are
themselves the victims of violence and intimidation, or are
dependent on drugs. An example of this phenomenon are
the drug ‘mules’ who take the most visible and risky roles in
the supply and delivery chain. Unlike those in charge of drug
trafficking organizations, these individuals do not usually have
an extensive and violent criminal history, and some engage
in the drug trade primarily to get money for their own drug
dependence. We should not treat all those arrested for
trafficking as equally culpable – many are coerced into their
actions, or are driven to desperate measures through their
own addiction or economic situation. It is not appropriate to
punish such individuals in the same way as the members of
violent organized crime groups who control the market.
Finally, many countries still react to people dependent on
drugs with punishment and stigmatization. In reality, drug
dependence is a complex health condition that has a mixture
of causes – social, psychological and physical (including, for
example, harsh living conditions, or a history of personal
trauma or emotional problems). Trying to manage this
complex condition through punishment is ineffective – much
greater success can be achieved by providing a range of
evidence-based drug treatment services. Countries that have
treated citizens dependent on drugs as patients in need of
treatment, instead of criminals deserving of punishment, have
demonstrated extremely positive results in crime reduction,
health improvement, and overcoming dependence.
PAT IE N TS NOT CR IMINALS:
A MO R E H UMANE AND E FF E CT IVE A P P RO A C H
Case Study One: Switzerland13
Case Study Two: United Kingdom15
In response to severe and highly visible drug
problems that developed across the country in
the 1980s, Switzerland implemented a new set of
policies and programs (including heroin substitution
programs) based on public health instead of
criminalization. The consistent implementation
of this policy has led to an overall reduction in
the number of people addicted to heroin as well
as a range of other benefits. A key study14
concluded that:
Research carried out in the UK into the effects
of their policy of diversion from custody into
treatment programs clearly demonstrated a
reduction in offending following treatment
intervention. In addition to self-reports, the
researchers in this case also referred to police
criminal records data. The research shows
that the numbers of charges brought against
1,476 drug users in the years before and after
entering treatment reduced by 48 percent.
“Heroin substitution targeted hard-core
problematic users (heavy consumers) – assuming
that 3,000 addicts represent 10 percent to
15 percent of Switzerland’s heroin users that may
account for 30 percent to 60 percent of the demand
for heroin on illegal markets. Heavily engaged in
both drug dealing and other forms of crime, they
also served as a link between wholesalers and users.
As these hard-core users found a steady, legal
means for their addiction, their illicit drug use was
reduced as well as their need to deal in heroin
and engage in other criminal activities.
Case Study Three: The Netherlands16,17,18
The heroin substitution program had three effects
on the drug market:
• It substantially reduced the consumption among
the heaviest users, and this reduction in demand
affected the viability of the market. (For example,
the number of new addicts registered in Zurich
in 1990 was 850. By 2005, the number had
fallen to 150.)
• It reduced levels of other criminal activity
associated with the market. (For example, there
was a 90 percent reduction in property crimes
committed by participants in the program.)
• By removing local addicts and dealers, Swiss casual
users found it difficult to make contact with sellers.”
Of all EU-15 countries, the percentage of people
who inject heroin is the lowest in the Netherlands
and there is no new influx of problematic users.
Heroin has lost its appeal to the mainstream youth
and is considered a ‘dead-end street drug’.
The number of problematic heroin users has
dropped significantly and the average age of users
has risen considerably. Large-scale, low-threshold
drug treatment and harm reduction services
include syringe access and the prescription of
methadone and heroin under strict conditions.
Medically prescribed heroin has been found
in the Netherlands to reduce petty crime and
public nuisance, and to have positive effects on
the health of people struggling with addiction.
In 2001, the estimated number of people in the
Netherlands dependent on heroin was 28-30,000.
By 2008, that number had fallen to 18,000.
The Dutch population of opiate users is in the
process of aging – the proportion of young
opiate users (aged 15-29) receiving treatment for
addiction has also declined.
Global Commission on Drug Policy
9
P R I NCI P L ES
(Continued)
3. The development and implementation of drug
policies should be a global shared responsibility,
but also needs to take into consideration diverse
political, social and cultural realities. Policies should
respect the rights and needs of people affected
by production, trafficking and consumption, as
explicitly acknowledged in the 1988 Convention
on Drug Trafficking.
The UN drug control system is built on the idea that
all governments should work together to tackle drug
markets and related problems. This is a reasonable
starting point, and there is certainly a responsibility to
be shared between producing, transit and consuming
countries (although the distinction is increasingly blurred,
as many countries now experience elements of all three).
However, the idea of shared responsibility has too often
become a straitjacket that inhibits policy development
and experimentation. The UN (through the International
Narcotics Control Board), and in particular the US
(notably through its ‘certification’ process), have worked
strenuously over the last 50 years to ensure that all
countries adopt the same rigid approach to drug policy
– the same laws, and the same tough approach to their
enforcement. As national governments have become
more aware of the complexities of the problems, and
options for policy responses in their own territories,
many have opted to use the flexibilities within the
Conventions to try new strategies and programs, such as
decriminalization initiatives or harm reduction programs.
When these involve a more tolerant approach to drug
use, governments have faced international diplomatic
pressure to ‘protect the integrity of the Conventions’,
even when the policy is legal, successful and supported
in the country.
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Global Commission on Drug Policy
A current example of this process (what may be described
as ‘drug control imperialism’), can be observed with the
proposal by the Bolivian government to remove the
practice of coca leaf chewing from the sections of the
1961 Convention that prohibit all non-medical uses.
Despite the fact that successive studies have shown19 that
the indigenous practice of coca leaf chewing is associated
with none of the harms of international cocaine markets,
and that a clear majority of the Bolivian population (and
neighboring countries) support this change, many of the
rich ‘cocaine consumer’ countries (led by the US) have
formally objected to the amendment.20
The idea that the international drug control system is
immutable, and that any amendment – however reasonable
or slight – is a threat to the integrity of the entire system,
is short-sighted. As with all multilateral agreements, the
drug conventions need to be subject to constant review
and modernization in light of changing and variable
circumstances. Specifically, national governments must
be enabled to exercise the freedom to experiment with
responses more suited to their circumstances. This analysis
and exchange of experiences is a crucial element of the
process of learning about the relative effectiveness of
different approaches, but the belief that we all need to have
exactly the same laws, restrictions and programs has been
an unhelpful restriction.
U N I N TE N DE D CONS E QU E N CES
The implementation of the war on drugs has generated
widespread negative consequences for societies in
producer, transit and consumer countries. These
negative consequences were well summarized by the
former Executive Director of the United Nations Office
on Drugs and Crime, Antonio Maria Costa, as falling into
five broad categories:
1. The growth of a ‘huge criminal black market’, financed
by the risk-escalated profits of supplying international
demand for illicit drugs.
2. Extensive policy displacement, the result of using scarce
resources to fund a vast law enforcement effort intended
to address this criminal market.
3. Geographical displacement, often known as ‘the balloon
effect’, whereby drug production shifts location to avoid
the attentions of law enforcement.
4. Substance displacement, or the movement of consumers
to new substances when their previous drug of choice
becomes difficult to obtain, for instance through law
enforcement pressure.
5. The perception and treatment of drug users, who are
stigmatized, marginalized and excluded.21
4. Drug policies must be pursued in a comprehensive
manner, involving families, schools, public health
specialists, development practitioners and civil society
leaders, in partnership with law enforcement agencies
and other relevant governmental bodies.
With their strong focus on law enforcement and
punishment, it is not surprising that the leading
institutions in the implementation of the drug control
system have been the police, border control and military
authorities directed by Ministries of Justice, Security
or Interior. At the multilateral level, regional or United
Nations structures are also dominated by these interests.
Although governments have increasingly recognized that
law enforcement strategies for drug control need to be
integrated into a broader approach with social and public
health programs, the structures for policymaking, budget
allocation, and implementation have not modernized at
the same pace.
These institutional dynamics obstruct objective and
evidence-based policymaking. This is more than
a theoretical problem – repeated studies22,23 have
demonstrated that governments achieve much greater
financial and social benefit for their communities by
investing in health and social programs, rather than
investing in supply reduction and law enforcement activities.
However, in most countries, the vast majority of available
resources are spent on the enforcement of drug laws and
the punishment of people who use drugs.24
The lack of coherence is even more marked at the
United Nations. The development of the global drug
control regime involved the creation of three bodies to
oversee the implementation of the conventions – the UN
Office on Drugs and Crime (UNODC), the International
Narcotics Control Board (INCB), and the Commission on
Narcotic Drugs (CND). This structure is premised on the
notion that international drug control is primarily a fight
against crime and criminals. Unsurprisingly, there is a
built-in vested interest in maintaining the law enforcement
focus and the senior decisionmakers in these bodies have
traditionally been most familiar with this framework.
Now that the nature of the drug policy challenge has
changed, the institutions must follow. Global drug policy
should be created from the shared strategies of all
interested multilateral agencies – UNODC of course, but
also UNAIDS, WHO, UNDP, UNICEF, UN Women, the
World Bank, and the Office of the High Commissioner on
Human Rights. The marginalization of the World Health
Organization is particularly worrisome given the fact that
it has been given a specific mandate under the drug
control treaties.
Global Commission on Drug Policy
9
R E COMMEN D AT IO NS
1. Break the taboo. Pursue an open debate
and promote policies that effectively reduce
consumption, and that prevent and reduce harms
related to drug use and drug control policies.
Increase investment in research and analysis into
the impact of different policies and programs.25
Political leaders and public figures should have the
courage to articulate publicly what many of them
acknowledge privately: that the evidence
overwhelmingly demonstrates that repressive
strategies will not solve the drug problem, and
that the war on drugs has not, and cannot, be won.
Governments do have the power to pursue a mix of
policies that are appropriate to their own situation,
and manage the problems caused by drug markets
and drug use in a way that has a much more positive
impact on the level of related crime, as well as social
and health harms.
2. Replace the criminalization and punishment of
people who use drugs with the offer of health and
treatment services to those who need them.
A key idea behind the ‘war on drugs’ approach
was that the threat of arrest and harsh punishment
would deter people from using drugs. In practice,
this hypothesis has been disproved – many countries
that have enacted harsh laws and implemented
widespread arrest and imprisonment of drug users and
low-level dealers have higher levels of drug use and
related problems than countries with more tolerant
approaches. Similarly, countries that have introduced
decriminalization, or other forms of reduction in arrest
or punishment, have not seen the rises in drug use or
dependence rates that had been feared.
DEC RIMINALIZAT ION INIT IAT IVE S
DO NOT RESULT IN SIGNIFIC A NT
INC REASES IN DRUG USE
Portugal
In July 2001, Portugal became the first European country
to decriminalize the use and possession of all illicit drugs.
Many observers were critical of the policy, believing that
it would lead to increases in drug use and associated
problems. Dr. Caitlin Hughes of the University of New
South Wales and Professor Alex Stevens of the University
of Kent have undertaken detailed research into the effects
of decriminalization in Portugal. Their recently published
findings26 have shown that this was not the case, replicating
the conclusions of their earlier study27 and that of the
CATO Institute28.
Hughes and Stevens’ 2010 report detects a slight increase
in overall rates of drug use in Portugal in the 10 years since
decriminalization, but at a level consistent with other similar
countries where drug use remained criminalized. Within this
general trend, there has also been a specific decline in the
use of heroin, which was in 2001 the main concern of the
Portuguese government. Their overall conclusion is that
the removal of criminal penalties, combined with the use
of alternative therapeutic responses to people struggling
with drug dependence, has reduced the burden of drug law
enforcement on the criminal justice system and the overall
level of problematic drug use.
Comparing Dutch and US Cities
A study by Reinarman, et. al. compared the very
different regulatory environments of Amsterdam, whose
liberal “cannabis cafe” policies (a form of de facto
decriminalization) go back to the 1970s, and San Francisco,
in the US, which criminalizes cannabis users. The researchers
wished to examine whether the more repressive policy
environment of San Francisco deterred citizens from
smoking cannabis or delayed the onset of use. They found
that it did not, concluding that:
“Our findings do not support claims that criminalization
reduces cannabis use and that decriminalization increases
cannabis use... With the exception of higher drug use in
San Francisco, we found strong similarities across both cities.
We found no evidence to support claims that criminalization
reduces use or that decriminalization increases use.”29
10
Global Commission on Drug Policy
Australia
The state of Western Australia introduced a
decriminalization scheme for cannabis in 2004, and
researchers evaluated its impact by comparing prevalence
trends in that state with trends in the rest of the country.
The study was complicated by the fact that it took place in
a period when the use of cannabis was in general decline
across the country. However, the researchers found that
this downward trend was the same in Western Australia,
which had replaced criminal sanctions for the use or
possession of cannabis with administrative penalties,
typically the receipt of a police warning called a ‘notice
of infringement’. The authors state:
“The cannabis use data in this study suggest that,
unlike the predictions of those public commentators
who were critical of the scheme, cannabis use in
Western Australia appears to have continued to decline
despite the introduction of the Cannabis Infringement
Notice Scheme.”30
3. Encourage experimentation by governments
with models of legal regulation of drugs (with
cannabis, for example) that are designed to
undermine the power of organized crime and
safeguard the health and security of their citizens.
The debate on alternative models of drug market
regulation has too often been constrained by false
dichotomies – tough or soft, repressive or liberal. In fact,
we are all seeking the same objective – a set of drug
policies and programs that minimize health and social
harms, and maximize individual and national security.
It is unhelpful to ignore those who argue for a taxed and
regulated market for currently illicit drugs. This is a
policy option that should be explored with the same
rigor as any other.32
If national governments or local administrations feel that
decriminalization policies will save money and deliver
better health and social outcomes for their communities,
or that the creation of a regulated market may reduce
the power of organized crime and improve the security
of their citizens, then the international community should
support and facilitate such policy experiments and learn
from their application.
Similarly, national authorities and the UN need to review
the scheduling of different substances. The current
schedules, designed to represent the relative risks and
harms of various drugs, were set in place 50 years ago
when there was little scientific evidence on which to
base these decisions. This has resulted in some obvious
anomalies – cannabis and coca leaf, in particular, now
seem to be incorrectly scheduled and this needs to
be addressed.
Comparisons Between Different States in the US
Although cannabis possession is a criminal offense under
US federal laws, individual states have varying policies
toward possession of the drug. In the 2008 Report of
the Cannabis Commission convened by the Beckley
Foundation, the authors reviewed research that had been
undertaken to compare cannabis prevalence in those
states that had decriminalized with those that maintained
criminal punishments for possession. They concluded that:
“Taken together, these four studies indicated that states
which introduced reforms did not experience greater
increases in cannabis use among adults or adolescents.
Nor did surveys in these states show more favorable
attitudes towards cannabis use than those states which
maintained strict prohibition with criminal penalties.”31
In the light of these experiences, it is clear that the
policy of harsh criminalization and punishment of drug
use has been an expensive mistake, and governments
should take steps to refocus their efforts and resources
on diverting drug users into health and social care
services. Of course, this does not necessarily mean that
sanctions should be removed altogether – many drug
users will also commit other crimes for which they need
to be held responsible – but the primary reaction to drug
possession and use should be the offer of appropriate
advice, treatment and health services to individuals who
need them, rather than expensive and counterproductive
criminal punishments.
Global Commission on Drug Policy
11
D I S C R E PANCIE S BE TWE E N
L E V E L S O F CONTR OL AND LEVELS O F HA RM
In a report published by The Lancet in 2007, a team of
scientists33 attempted to rank a range of psychoactive
drugs according to the actual and potential harms they
could cause to society. The graph at right summarizes
their findings and contrasts them with the seriousness
with which the drugs are treated within the global
drug control system.
While these are crude assessments, they clearly
show that the categories of seriousness ascribed to
various substances in international treaties need to be
reviewed in the light of current scientific knowledge.
INDEPENDENT EXPERT
A SSESSMENT S O F RISK
0.00.51.01.52.02.53.0
Heroin
Cocaine
Barbiturates
Alcohol
Ketamine
U N C L AS S IFICATION
Benzodiazepines
Most Dangerous
Amphetamine
Moderate Risk
Tobacco
Low Risk
Buprenorphine
Not Subject to International Control
Cannabis
Solvents
LSD
Ritalin
Anabolic Steroids
GHB
Ecstasy
Khat
10
Global Commission on Drug Policy
R E COMMEN D AT IO NS
(Continued)
4. Establish better metrics, indicators and goals to
measure progress.
The current system of measuring success in the drug
policy field is fundamentally flawed.34 The impact of
most drug strategies are currently assessed by the level
of crops eradicated, arrests, seizures and punishments
applied to users, growers and dealers. In fact, arresting
and punishing drug users does little to reduce levels
of drug use, taking out low-level dealers simply creates
a market opportunity for others, and even the largest
and most successful operations against organized
criminals (that take years to plan and implement) have
been shown to have, at best, a marginal and shortlived impact on drug prices and availability. Similarly,
eradication of opium, cannabis or coca crops merely
displaces illicit cultivation to other areas.
A new set of indicators is needed to truly show the
outcomes of drug policies, according to their harms or
benefits for individuals and communities – for example,
the number of victims of drug market-related violence
and intimidation; the level of corruption generated
by drug markets; the level of petty crime committed
by dependent users; levels of social and economic
development in communities where drug production,
selling or consumption are concentrated; the level of
drug dependence in communities; the level of overdose
deaths; and the level of HIV or hepatitis C infection
among drug users. Policymakers can and should
articulate and measure the outcome of these objectives.
The expenditure of public resources should therefore
be focused on activities that can be shown to have
a positive impact on these objectives. In the current
circumstances in most countries, this would mean
increased investment in health and social programs,
and improved targeting of law enforcement resources
to address the violence and corruption associated with
drug markets.35 In a time of fiscal austerity, we can no
longer afford to maintain multibillion dollar investments
that have largely symbolic value.
5. Challenge, rather than reinforce, common
misconceptions about drug markets, drug use
and drug dependence.
Currently, too many policymakers reinforce the idea
that all people who use drugs are ‘amoral addicts’, and
all those involved in drug markets are ruthless criminal
masterminds. The reality is much more complex.
The United Nations makes a conservative estimate
that there are currently 250 million illicit drug users in
the world, and that there are millions more involved
in cultivation, production and distribution. We simply
cannot treat them all as criminals.
To some extent, policymakers’ reluctance to
acknowledge this complexity is rooted in their
understanding of public opinion on these issues.
Many ordinary citizens do have genuine fears about the
negative impacts of illegal drug markets, or the behavior
of people dependent on, or under the influence of,
illicit drugs. These fears are grounded in some general
assumptions about people who use drugs and drug
markets, that government and civil society experts need
to address by increasing awareness of some established
(but largely unrecognized) facts. For example:
• The majority of people who use drugs do not fit the
stereotype of the ‘amoral and pitiful addict’. Of the
estimated 250 million drug users worldwide, the United
Nations estimates that less than 10 percent can be
classified as dependent, or ‘problem drug users’.36
• Most people involved in the illicit cultivation of coca,
opium poppy, or cannabis are small farmers struggling
to make a living for their families. Alternative livelihood
opportunities are better investments than destroying
their only available means of survival.
• The factors that influence an individual’s decision to
start using drugs have more to do with fashion, peer
influence, and social and economic context, than with
the drug’s legal status, risk of detection, or government
prevention messages.37, 38
• The factors that contribute to the development of
problematic or dependent patterns of use have more
to do with childhood trauma or neglect, harsh living
conditions, social marginalization, and emotional
problems, rather than moral weakness or hedonism.39
Global Commission on Drug Policy
13
R E COMMEN D AT IO NS
(Continued)
• It is not possible to frighten or punish someone out of drug
dependence, but with the right sort of evidence-based
treatment, dependent users can change their behavior and
be active and productive members of the community.40
• Most people involved in drug trafficking are petty dealers
and not the stereotyped gangsters from the movies – the
vast majority of people imprisoned for drug dealing or
trafficking are ‘small fish’ in the operation (often coerced
into carrying or selling drugs), who can easily be replaced
without disruption to the supply.41,42
A more mature and balanced political and media discourse
can help to increase public awareness and understanding.
Specifically, providing a voice to representatives of farmers,
users, families and other communities affected by drug
use and dependence can help to counter myths and
misunderstandings.
6. Countries that continue to invest mostly in a law
enforcement approach (despite the evidence) should
focus their repressive actions on violent organized
crime and drug traffickers, in order to reduce the
harms associated with the illicit drug market.
The resources of law enforcement agencies can be much
more effectively targeted at battling the organized crime
groups that have expanded their power and reach on the
back of drug market profits. In many parts of the world,
the violence, intimidation and corruption perpetrated
by these groups is a significant threat to individual and
national security and to democratic institutions, so efforts
by governments and law enforcement agencies to curtail
their activities remain essential.
However, there is a need to review our tactics in this fight.
There is a plausible theory put forward by MacCoun and
Reuter43 that suggests that supply reduction efforts are
most effective in a new and undeveloped market, where
the sources of supply are controlled by a small number
of trafficking organizations. Where these conditions exist,
appropriately designed and targeted law enforcement
operations have the potential to stifle the emergence of
new markets. We face such a situation now in West Africa.
On the other hand, where drug markets are diverse and
well-established, preventing drug use by stopping supply
is not a realistic objective.
14
Global Commission on Drug Policy
DRUGS IN W EST A FRIC A :
RESP ONDING T O T HE GRO W IN G
C HA LLENGE O F NA RC O T RAFFI C
AND O RGANIZED C RIME
In just a few years, West Africa has become a major transit
and re-packaging hub for cocaine following a strategic shift
of Latin American drug syndicates toward the European
market. Profiting from weak governance, endemic poverty,
instability and ill-equipped police and judicial institutions,
and bolstered by the enormous value of the drug trade,
criminal networks have infiltrated governments, state
institutions and the military. Corruption and money
laundering, driven by the drug trade, pervert local politics
and skew local economies.
A dangerous scenario is emerging as narco-traffic threatens
to metastasize into broader political and security challenges.
Initial international responses to support regional and
national action have not been able to reverse this trend. New evidence44 suggests that criminal networks are
expanding operations and strengthening their positions
through new alliances, notably with armed groups. Current
responses need to be urgently scaled up and coordinated
under West African leadership, with international financial
and technical support. Responses should integrate
law enforcement and judicial approaches with social,
development and conflict prevention policies – and they
should involve governments and civil society alike.
We also need to recognize that it is the illicit nature of the
market that creates much of the market-related violence
– legal and regulated commodity markets, while not
without problems, do not provide the same opportunities
for organized crime to make vast profits, challenge the
legitimacy of sovereign governments, and, in some cases,
fund insurgency and terrorism.
This does not necessarily mean that creating a legal
market is the only way to undermine the power and
reach of drug trafficking organizations. Law enforcement
strategies can explicitly attempt to manage and shape
the illicit market by, for example, creating the conditions
where small-scale and private ‘friendship network’ types
of supply can thrive, but cracking down on larger-scale
operations that involve violence or inconvenience to the
general public. Similarly, the demand for drugs from those
dependent on some substances (for example, heroin)
can be met through medical prescription programs that
automatically reduce demand for the street alternative.
Such strategies can be much more effective in reducing
market-related violence and harms than futile attempts
to eradicate the market entirely.
On the other hand, poorly designed drug law enforcement
practices can actually increase the level of violence,
intimidation and corruption associated with drug
markets. Law enforcement agencies and drug trafficking
organizations can become embroiled in a kind of ‘arms
race’, in which greater enforcement efforts lead to a similar
increase in the strength and violence of the traffickers.
In this scenario, the conditions are created in which the
most ruthless and violent trafficking organizations thrive.
Unfortunately, this seems to be what we are currently
witnessing in Mexico and many other parts of the world.
LAW ENFORC EMENT A ND
T HE ESC A LAT ION OF VIOLENCE
A group of academics and public health experts based
in British Columbia have conducted a systematic review
of evidence45 relating to the impact of increased law
enforcement on drug market-related violence (for example,
armed gangs fighting for control of the drug trade, or
homicide and robberies connected to the drug trade).
In multiple US locations, as well as in Sydney, Australia,
the researchers found that increased arrests and law
enforcement pressures on drug markets were strongly
associated with increased homicide rates and other
violent crimes. Of all the studies examining the effect of
increased law enforcement on drug market violence,
91 percent concluded that increased law enforcement
actually increased drug market violence. The researchers
concluded that:
“The available scientific evidence suggests that
increasing the intensity of law enforcement interventions
to disrupt drug markets is unlikely to reduce drug gang
violence. Instead, the existing evidence suggests that
drug-related violence and high homicide rates are likely
a natural consequence of drug prohibition and that
increasingly sophisticated and well-resourced methods of
disrupting drug distribution networks may unintentionally
increase violence.”46
In the UK also, researchers have examined the effects of
policing on drug markets, noting that:
“Law enforcement efforts can have a significant negative
impact on the nature and extent of harms associated with
drugs by (unintentionally) increasing threats to public
health and public safety, and by altering both the behavior
of individual drug users and the stability and operation of
drug markets (e.g. by displacing dealers and related activity
elsewhere or increasing the incidence of violence
as displaced dealers clash with established ones).”47
Global Commission on Drug Policy
15
R E COMMEN D AT IO NS
(Continued)
7. Promote alternative sentences for small-scale and
first-time drug dealers.
While the idea of decriminalization has mainly been
discussed in terms of its application to people who use
drugs or who are struggling with drug dependence,
we propose that the same approach be considered
for those at the bottom of the drug selling chain.
The majority of people arrested for small-scale drug
selling are not gangsters or organized criminals.
They are young people who are exploited to do the
risky work of street selling, dependent drug users trying
to raise money for their own supply, or couriers coerced
or intimidated into taking drugs across borders. These
people are generally prosecuted under the same legal
provisions as the violent and organized criminals who
control the market, resulting in the indiscriminate
application of severe penalties.
Around the world, the vast majority of arrests are of
these nonviolent and low-ranking ‘little fish’ in the drug
market. They are most visible and easy to catch, and do
not have the means to pay their way out of trouble.48
The result is that governments are filling prisons with
minor offenders serving long sentences, at great cost,
and with no impact on the scale or profitability of
the market.
In some countries, these offenders are even subject to
the death penalty, in clear contravention of international
human rights law. To show their commitment to
fighting the drug war, many countries implement laws
and punishments that are out of proportion to the
seriousness of the crime, and that still do not have a
significant deterrent effect. The challenge now is for
governments to look at diversion options for the ‘little
fish’, or to amend their laws to make a clearer and more
proportionate distinction between the different types of
actors in the drug market.
rates of drug use through mass prevention campaigns
were poorly planned and implemented. While the
presentation of good (and credible) information on
the risks of drug use is worthwhile, the experience of
universal prevention (such as media campaigns, or
school-based drug prevention programs) has been
mixed. Simplistic ‘just say no’ messages do not seem
to have a significant impact.49
There have been some carefully planned and targeted
prevention programs, however, that focus on social skills
and peer influences that have had a positive impact on
the age of initiation or the harms associated with drug
use. The energy, creativity and expertise of civil society
and community groups are of particular importance
in the design and delivery of these programs. Young
people are less likely to trust prevention messages
coming from state agencies.
Successful models of prevention have tended to target
particular groups at risk – gang members, children in
care, or in trouble at school or with the police – with
mixed programs of education and social support that
prevent a proportion of them from developing into
regular or dependent drug users. Implemented to a
sufficient scale, these programs have the potential
to reduce the overall numbers of young people who
become drug dependent or who get involved in
petty dealing.
9. Offer a wide and easily accessible range of options
for treatment and care for drug dependence,
including substitution and heroin-assisted treatment,
with special attention to those most at risk, including
those in prisons and other custodial settings.
In all societies and cultures, a proportion of individuals
will develop problematic or dependent patterns of
drug use, regardless of the preferred substances in that
society or their legal status. Drug dependence can be
a tragic loss of potential for the individual involved,
but is also extremely damaging for their family, their
community, and, in aggregate, for the entire society.
Preventing and treating drug dependence is therefore
a key responsibility of governments – and a valuable
investment, since effective treatment can deliver
significant savings in terms of reductions in crime and
improvements in health and social functioning.
8. Invest more resources in evidence-based prevention,
with a special focus on youth.
Clearly, the most valuable investment would be in
activities that stop young people from using drugs in
the first place, and that prevent experimental users
from becoming problematic or dependent users.
Prevention of initiation or escalation is clearly preferable
to responding to the problems after they occur.
Unfortunately, most early attempts at reducing overall
16
Global Commission on Drug Policy
Many successful treatment models – using a mix of
substitution treatment and psycho-social methods
– have been implemented and proven in a range of
socio-economic and cultural settings. However, in
most countries, the availability of these treatments is
limited to single models, is only sufficient to meet a
small fraction of demand, or is poorly targeted and fails
to focus resources on the most severely dependent
individuals. National governments should therefore
develop comprehensive, strategic plans to scale
up a menu of evidence-based drug dependence
treatment services.
At the same time, abusive practices carried out in the
name of treatment – such as forced detention, forced
labor, physical or psychological abuse – that contravene
human rights standards by subjecting people to cruel,
inhuman and degrading treatment, or by removing
the right to self-determination, should be abolished.
Governments should ensure that their drug dependence
treatment facilities are evidence-based and comply with
international human rights standards.
UN drug control institutions have largely acted as
defenders of traditional policies and strategies. In the
face of growing evidence of the failure of these strategies,
reforms are necessary. There has been some encouraging
recognition by UNODC that there is a need to balance
and modernize the system, but there is also strong
institutional resistance to these ideas.
Countries look to the UN for support and guidance.
The UN can, and must, provide the necessary leadership
to help national governments find a way out of the current
policy impasse. We call on UN Secretary General Ban
Ki-moon and UNODC Executive Director Yury Fedotov
to take concrete steps toward a truly coordinated and
coherent global drug strategy that balances the need
to stifle drug supply and fight organized crime with the
need to provide health services, social care, and economic
development to affected individuals and communities.
There are a number of ways to make progress on this
objective. For a start, the UN could initiate a wideranging commission to develop a new approach; UN
agencies could create new and stronger structures for
policy coordination; and the UNODC could foster more
meaningful program coordination with other UN agencies
such as the WHO, UNAIDS, UNDP, or the Office of the
UN High Commissioner for Human Rights.
10.The United Nations system must provide leadership
in the reform of global drug policy. This means
promoting an effective approach based on evidence,
supporting countries to develop drug policies
that suit their context and meet their needs, and
ensuring coherence among various UN agencies,
policies and conventions.
11. Act urgently: the war on drugs has failed, and
policies need to change now.
There are signs of inertia in the drug policy debate in
some parts of the world, as policymakers understand
that current policies and strategies are failing but do not
know what to do instead. There is a temptation to avoid
the issue. This is an abdication of policy responsibility –
for every year we continue with the current approach,
billions of dollars are wasted on ineffective programs,
millions of citizens are sent to prison unnecessarily,
millions more suffer from the drug dependence of
loved ones who cannot access health and social care
services, and hundreds of thousands of people die from
preventable overdoses and diseases contracted through
unsafe drug use.
There are other approaches that have been proven to
tackle these problems that countries can pursue now.
Getting drug policy right is not a matter for theoretical or
intellectual debate – it is one of the key policy challenges
of our time.
While national governments have considerable
discretion to move away from repressive policies,
the UN drug control system continues to act largely
as a straitjacket, limiting the proper review and
modernization of policy. For most of the last century,
it has been the US government that has led calls for
the development and maintenance of repressive drug
policies. We therefore welcome the change of tone
emerging from the current administration50 – with
President Obama himself acknowledging the futility
of a ‘war on drugs’ and the validity of a debate on
alternatives.51 It will be necessary, though, for the US to
follow up this new rhetoric with real reform, by reducing
its reliance on incarceration and punishment of drug
users, and by using its considerable diplomatic influence
to foster reform in other countries.
Global Commission on Drug Policy
17
E ND NO T ES
For detailed analysis of illicit drug markets over the decade, see: Reuter,
P. and Trautmann, F. (2009) A Report on Global Illicit Drug Markets
1998-2007. European Commission http://www.exundhopp.at/www1/
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14
UNODC (2008) 2008 World Drug Report Vienna: United Nations
http://www.unodc.org/unodc/en/data-and-analysis/WDR-2008.html
Accessed 04.19.11
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1
2
Killias, M. and Aebi, M.F. (2000) “The impact of heroin prescription on
heroin markets in Switzerland,” Crime Prevention Studies, volume 11,
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National Drug Intelligence Centre (2010) National Drug Threat
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3
National Drug Monitor (2009) NDM Annual Report, 2009 WODC/Trimbos
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Office of the United Nations High Commissioner for Human Rights (2009)
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international drug policy Geneva: United Nations http://www.ohchr.org/
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World Health Organization, UN Office on Drugs and Crime, and Joint UN
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Nederlandse drugsbeleid WODC/Trimbos Instituut http://www.trimbos.
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support system for drug users IDPC Briefing Paper, January 2011
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Henman, A. and Metaal, P. (2009) Coca Myths Transnational Institute Drugs
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http://www.emcdda.europa.eu/publications/monographs/harm-reduction
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20
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themes/harm-reduction Accessed 04.19.11
21
7
8
Mathers, B., Degenhardt, L., Phillips, B., Wiessing, L., Hickman, M.,
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22
Reuter, P. and Pollack, H. (2006) “How much can treatment reduce national
drug problems?” Addiction 101 (3) pp. 341-347
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10
WHO (2006) Treatment of Injecting Drug Users with HIV/AIDS:
Promoting Access and Optimizing Service Delivery Geneva: World
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Carnevale, J. (2009) Restoring the Integrity of the Office of National
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http://www.idpc.net/publications/john-carnevale-testimony-ONDCPcongress Accessed 04.21.11
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Bühringer, G., Farrell, M., Kraus, L., Marsden, J., Pfeiffer-Gerschel, T.,
Piontek, D., Karachaliou, K., Künzel, J. and Stillwell, G. (2009) Comparative
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18
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42
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Perry, C. L., Komro, K. A., Veblen-Mortenson, S., Bosma, L. M., Farbakhsh,
K., Munson, K. A., et al. (2003) “A randomized controlled trial of the
middle and junior high school D.A.R.E. and D.A.R.E. Plus programs”
Archives of Pediatrics & Adolescent Medicine 157(2), pp. 178-184
49
Hallam, C. and Bewley-Taylor, D. (2010) “Mapping the World Drug
Problem: Science and Politics in the United Nations Drug Control
System,” International Journal of Drug Policy, Volume 21, (1), 2010, pp. 1-3
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Caulkins, J., Reuter, P. Iguchi, M.Y. and Chiesa, J. (2005) How Goes the
“War on drugs”? An Assessment of US Problems and Policy Santa Monica,
California: RAND http://www.rand.org/pubs/occasional_papers/2005/
RAND_OP121.pdf Accessed 04.20.11
35
Office of National Drug Control Policy (2010) National Drug Control
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“Obama: Drugs Should be Treated as a Public Health Problem”
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Global Commission on Drug Policy
19
S E C R E TA R I AT
BAC KGROUND PAP ERS
(available at www.globalcommissionondrugs.org)
Bernardo Sorj
Ilona Szabó de Carvalho
Miguel Darcy de Oliveira
Demand reduction and harm reduction
Dr. Alex Wodak
A D V IS O R S
Drug policy, criminal justice and mass imprisonment
Bryan Stevenson
Dr. Alex Wodak, Australian Drug Law
Reform Foundation
www.adlrf.org.au
Assessing supply-side policy and practice: eradication
and alternative development
David Mansfield
Ethan Nadelmann, Drug Policy Alliance
www.drugpolicy.org
The development of international drug control: lessons
learned and strategic challenges for the future
Martin Jelsma
Martin Jelsma, Transnational Institute
www.tni.org/drugs
Mike Trace, International Drug Policy Consortium
www.idpc.net
S U PPO R T
Centro Edelstein de Pesquisas Sociais
Instituto Fernando Henrique Cardoso
Open Society Foundations
Sir Richard Branson, founder and chairman of
Virgin Group (Support provided through
Virgin Unite)
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Global Commission on Drug Policy
Drug policy: lessons learned and options for the future
Mike Trace
The drug trade: the politicization of criminals and
the criminalization of politicians
Moisés Naím
FO R ADDIT IONA L RESO URC ES, SE E :
www.unodc.org
www.idpc.net
www.drugpolicy.org
www.talkingdrugs.org
www.tni.org/drugs
www.ihra.net
www.countthecosts.org
www.intercambios.org.ar
www.cupihd.org
www.wola.org/program/drug_policy
www.beckleyfoundation.org
www.comunidadesegura.org
G L O B A L COMMIS S ION ON
D R U G PO LICY
The purpose of the Global Commission on Drug Policy
is to bring to the international level an informed,
science-based discussion about humane and effective
ways to reduce the harm caused by drugs to people
and societies.
GOALS
• Review the basic assumptions, effectiveness and
consequences of the ‘war on drugs’ approach
• Evaluate the risks and benefits of different national
responses to the drug problem
• Develop actionable, evidence-based recommendations
for constructive legal and policy reform
www.globalcommissionondrugs.org
22
Global Commission on Drug Policy